What is the goal of defunding Obamacare?

Saturday

Sep 21, 2013 at 12:01 AM

The drumbeat, if one is needed, should be to improve Obamacare, not “defund” it.

By MARK LIPTON

PANAMA CITY BEACH Televised ads deriding Obamacare, urging that it be defunded, and a movement in Congress to shut down the government unless the Affordable Care Act is dismantled are underway. What is troubling is the lack of specificity explaining the goal of the movement. What will be defunded? Since Obamacare has several components, each should be considered separately. We are entitled to be told what the shouting is about. Threats that could once again affect the country’s credit rating, economic recovery and the overall welfare of our nation cannot go unchallenged.

The law’s name is the Patient Protection and Affordable Care Act. Do those who oppose it want to defund patient protections? This portion protects and benefits every citizen and costs the government nothing. It is insurance regulation: 1) eliminating pre-existing conditions, 2) requiring that preventative services (of which there are many) be provided with no co-pays or deductibles, 3) eliminating lifetime and annual limits, and 4) allowing children through age 25 to remain on parents’ insurance.

Preventative care should be encouraged, for in the long run it saves money. An early diagnosis of hypertension can avoid later bypass surgery. Generic medications and diet, if prescribed early, can prevent insulin-dependent diabetes and its consequences, including retinopathy and neuropathy (the former requiring retinal laser treatments and the latter limb amputation).

The law’s patient protections also prevent insurance companies from canceling policies after claims have been submitted because of minor errors on applications.

Finally, Obamacare mandates insurance companies spend 80 to 85 percent of premiums on benefits, not CEO salaries, stock dividends or elaborate expenses. Failure to do so results in premium rebates. Already more than $1 billion has been rebated. The government does not “fund” any of these protections. Do the “defunders” really want these protections eliminated?

The health exchanges/marketplaces go into effect Jan. 1. Are they the target? The exchanges provide affordable options for individuals and small businesses. The government originally estimated that 7 million Americans would apply for insurance coverage through the exchanges. According to USA Today the number looks more like 8.5 million. This is good news. The more people in the exchanges, the broader the group over which the risk of claims will be spread, keeping costs down.

The exchanges, offered online with four levels of benefits (bronze, silver, gold and platinum), will provide comprehensive health coverage (medical and prescription) and offer sliding-scale subsidies for low-income Americans. They will consist of multiple providers, including one nonprofit entity. Do the “defunders” want to eliminate the subsidies for low-income Americans? Eliminate the exchanges?

Isn’t Medicaid available for low-income Americans? Medicaid eligibility in Florida for a single adult requires monthly income of less than $354. To Florida’s credit, the rules are less strict for individuals on Supplemental Security Income (SSI), those who are disabled, blind or aged. Additionally, if a family has children or a woman is pregnant, the income thresholds are higher. However, for a low-income earner or couple without children, Medicaid is not available. The $354 limit would be raised if Florida were to adopt the Medicaid expansion, but it has declined to do so. Each state can make that election to expand Medicaid or not without having Obamacare defunded.

So again, one must ask, what is the defunding goal? To eradicate the patient protections of the law? Eliminate the exchanges that make available affordable health insurance for middle- and low-income earners? Stop Medicaid expansion? Are the Obamacare opponents concerned that once the exchanges go into effect Jan. 1, 2014 they will be so popular that any chance of repealing Obamacare (if there were one) will evaporate like the reasons behind the defunding movement? We can only guess what fuels the foolishness — but be sure it is foolishness and cannot be endorsed as anything else.

The drumbeat, if one is needed, should be to improve Obamacare, not “defund” it. If those who oppose the law have suggestions to make it better then let them speak up and share those suggestions. We will listen.

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